1821133562 NPI number — MRS. ELIZABETH ANN FLAHIVE P.T.

Table of content: MRS. ELIZABETH ANN FLAHIVE P.T. (NPI 1821133562)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821133562 NPI number — MRS. ELIZABETH ANN FLAHIVE P.T.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FLAHIVE
Provider First Name:
ELIZABETH
Provider Middle Name:
ANN
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
P.T.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
FLAHIVE
Provider Other First Name:
BEA
Provider Other Middle Name:
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
PHYSICAL THERAPIST
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1821133562
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2216 HAWK DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BETTENDORF
Provider Business Mailing Address State Name:
IA
Provider Business Mailing Address Postal Code:
52722-6270
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
563-332-9653
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
729 21ST ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BETTENDORF
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
52722-5004
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
563-344-6268
Provider Business Practice Location Address Fax Number:
563-359-5967
Provider Enumeration Date:
02/20/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 251300000X , with the licence number:  25100000X , registered in the state of IA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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